Provider Demographics
NPI:1992986285
Name:DAVID T. JOHNSON D.M.D
Entity type:Organization
Organization Name:DAVID T. JOHNSON D.M.D
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:615-895-2710
Mailing Address - Street 1:117 SULPHUR SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37129-2117
Mailing Address - Country:US
Mailing Address - Phone:615-895-2710
Mailing Address - Fax:615-895-2878
Practice Address - Street 1:117 SULPHUR SPRINGS RD
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-2117
Practice Address - Country:US
Practice Address - Phone:615-895-2710
Practice Address - Fax:615-895-2878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-15
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty